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Louis-Delsoin C, Ruiz-Rodrigo A, Rousseau J. Understanding the home environment of older adults living with dementia: A scoping review of assessment tools. Home Health Care Serv Q 2024; 43:54-86. [PMID: 38146743 DOI: 10.1080/01621424.2023.2290708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Rigorous assessments to better understand the person-environment interaction are essential to comprehend how neurocognitive disorders influence in-home functioning of older people living with dementia. No recent synthesis identifies validated instruments targeting the human (e.g. caregivers) and nonhuman (e.g. objects) elements of the home environment interacting with this population and used with the perspective of aging in place. Consequently, following Arksey and O'Malley's (2005) scoping review method, 2,182 articles were identified in six databases and in gray literature. Two reviewers independently selected 23 relevant articles describing 19 validated assessment tools targeting elements of the home interacting with older people with dementia, namely: nonhuman environment (n = 13), human environment (n = 3), and person-environment interaction (n = 3). This overview highlights the scarcity of tools addressing the human environment and the person-environment interaction to foster sustainable at-home living for older people with neurocognitive disorders, demonstrating the need to incorporate new evidence-based, holistic methods into dementia home care.
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Affiliation(s)
- Cindy Louis-Delsoin
- School of rehabilitation, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Alicia Ruiz-Rodrigo
- School of rehabilitation, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Jacqueline Rousseau
- School of rehabilitation, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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Kłosińska U, Leszko M. Family relationships as a source of narrative identity of people with advanced dementia. BMC Geriatr 2023; 23:546. [PMID: 37684570 PMCID: PMC10492413 DOI: 10.1186/s12877-023-04258-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The growing body of research on narrative identity, while helpful, rarely focuses on people with dementia. In this paper, we explore how individuals living with advanced dementia construct their narrative identities in relation to their family experiences, which play a crucial role in shaping identity as shown by recent studies. METHODS We conducted a qualitative study using data from 15 semi-structured interviews with people aged 66 to 94 who have advanced dementia. The data were analyzed using a textual-oriented discourse analysis. RESULTS We identified two discourses-autobiographical and economic-that organize their narrative identities. Through the autobiographical discourse, participants emphasized their sense of belonging within a social group and their role as custodians of family identity. Within the economic discourse, they negotiated their social utility and value, particularly in response to demeaning discourses targeting individuals who do not accumulate wealth. In the structural analysis, we identified two narrative types-looped or unfolding-that depend on their affective experiences related to their family. We especially explored how the repetition of narrative threads by individuals with dementia might indicate a traumatic background rather than just memory disruptions. CONCLUSIONS This study provides insights into the narrative identities of individuals with advanced dementia, shedding light on the intersection of family experiences and identity formation in this population.
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Affiliation(s)
- Urszula Kłosińska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, ul. Ostrowskiego 30B, Wrocław, 53-238, Poland.
| | - Magdalena Leszko
- Department of Psychology, University of Szczecin, Szczecin, Poland
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Kłosińska U, Ziółkowska J. Discourses of work life in narrative identities of people with advanced dementia. Int J Geriatr Psychiatry 2023; 38:e5921. [PMID: 37173832 DOI: 10.1002/gps.5921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES There is no consensus as to whether people with advanced dementia can create a narrative identity. It is most often thought to be disturbed due to autobiographical memory disorders. In this paper, we examined how people with advanced dementia constructed their narrative identities in relation to their professional experience. METHODS This qualitative study used data obtained from 8 semi-structured interviews. The interviewees were people with advanced dementia aged between 66 and 89 years. We analyzed the dataset based on the textual-oriented discourse analysis. RESULTS The study participants created narrative identities. Their narrative identities were constructed within residual professional discourses learned during their lifespan. These discourses blended their narrative identities into coherent stories about who they are now, offered languages to describe current experiences, and emphasized important values for their self-image. The participants built narrative identities by referring to the past and imagining a better present with the omission of the future. The past was valued positively and was a source of positive nostalgia. Projections of a better present served to reveal their needs and assess ways to meet them. CONCLUSIONS We argue that people with advanced dementia can create complex and coherent narrative identities. They are constructed around discourses and not only using autobiographical memories. Encouraging them to create narrative identities in the dialogue can be a simple therapeutic method by which they can maintain a sense of self-cohesion and belonging to the world.
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Affiliation(s)
- Urszula Kłosińska
- SWPS University of Social Sciences and Humanities, Faculty of Psychology, Wrocław, Poland
| | - Justyna Ziółkowska
- SWPS University of Social Sciences and Humanities, Faculty of Psychology, Wrocław, Poland
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Mentzou A, Sixsmith J, Ellis MP, Ross J. Change in the psychological self in people living with dementia: A scoping review. Clin Psychol Rev 2023; 101:102268. [PMID: 36898295 DOI: 10.1016/j.cpr.2023.102268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/02/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Alterations in one's sense of self are often considered a significant psychological symptom of dementia. However, the self is not a unified construct; it consists of a set of closely connected, yet substantive, manifestations which might not be equally impacted by dementia. Recognising the multidimensional nature of the self, the current scoping review aimed to explore the nature and scope of the evidence demonstrating change in the psychological self in people living with dementia. Adopting a cognitive psychological framework, a hundred and five (105) quantitative and qualitative studies were reviewed, and findings were organised into three main types of self-manifestations: high-order manifestations, functional aspects of the self, and foundational manifestations. Overall, the results show that although there are alterations in some of these different manifestations of the self, these do not imply a global loss of selfhood. Despite notable cognitive changes during dementia, it seems that preserved aspects of self may be enough to compensate for potential weakening of some self-processes such as autobiographical recall. Better understanding alterations in selfhood is key to addressing psychological symptoms of people living with dementia, such as feelings of disconnection and reduced agency, and may inform new pathways for dementia care interventions.
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Affiliation(s)
- Aikaterini Mentzou
- School of Humanities, Social Sciences and Law, Division of Psychology, University of Dundee, Scotland, UK.
| | - Judith Sixsmith
- School of Health Sciences, University of Dundee, Scotland, UK
| | - Maggie P Ellis
- School of Psychology and Neuroscience, University of St Andrews, Scotland, UK
| | - Josephine Ross
- School of Humanities, Social Sciences and Law, Division of Psychology, University of Dundee, Scotland, UK
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HONG M, ZHENG J, DYAKOV DG, LV S. CONTENT AND CHARACTERISTICS OF SELF-IDENTITY AMONG CHINESE COLLEGE STUDENTS WITH INTERNET ADDICTION IN SNS USE: A THEMATIC ANALYSIS. PSYCHOLOGIA 2022. [DOI: 10.2117/psysoc.2021-a168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ming HONG
- Belarusian State Pedagogical University
| | - Jianhong ZHENG
- Guangdong Provincial Key Laboratory of Development and Education for Special Needs Children
| | | | - Sansan LV
- Guangdong Provincial Key Laboratory of Development and Education for Special Needs Children
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Abstract
Abstract
Personhood has been a key influence on the development of person-centred care models in dementia. However, there is ambiguity around the concept and interpretation of personhood, and what it means in practical terms for the delivery of care to people with dementia. This study examines the conceptualisation of personhood within the formal care system for people with dementia in Ireland. A multiple perspective study design examines the experiences of personhood in dementia from the perspectives of people with dementia, family carers and a range of formal carers. Semi-structured interviews with participants were conducted in both community and long-term care settings. Interpretative phenomenological analysis is used to examine the data. A total of 31 participants were interviewed: eight people with dementia, eight family carers and 15 formal carers. There is general consensus on the core elements of personhood among all participants: interests and preferences; lifecourse experiences; social interaction; family; and place. However, there is ambiguity among family carers and formal carers in the interpretation of changes to personhood as the disease progresses. Interpersonal and structural barriers to supporting personhood are identified by all participants. The findings provide guidance on the traits of personhood-enhancing care, including effective communication skills, and the potential of health and social care reform to support the core elements of personhood among people with dementia.
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Dolatkhah R, Shabanloei R, Ebrahimi H, Ghasempour M. Content analysis of identity challenges in patients with haemophilia: A qualitative study. Nurs Open 2021; 8:1444-1451. [PMID: 33405396 PMCID: PMC8046095 DOI: 10.1002/nop2.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 11/26/2022] Open
Abstract
Aims Inherited bleeding diseases greatly affect education, working, job, social activities and quality of life. We aimed to discover the sources of identity challenges among patients with Haemophilia. Design The present study has been designed and performed as a qualitative content analysis research. Methods Participants were purposively selected from haemophilia patients referred to our clinic during one year, from March 2018 to April 2019. Data collection was done through semi‐structured, in‐depth interviews using purposeful sampling. Data were analysed based on Granheme and Landman method. The main categories were fear of rejection, losing social roles, discrimination and stigma and marriage breakdown. Results Patients with haemophilia encounter several challenges due to physical and social constraints caused by the disease. Such challenges result in disturbances in the self‐identity of the patients. Conclusion According to the results of this study, the nurses should plan to have attention to the patients with haemophilia, based on more protection and better supports.
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Affiliation(s)
- Roya Dolatkhah
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Shabanloei
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Ebrahimi
- Department of Psychiatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Ghasempour
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Olsen M, Udo C, Boström AM, Hammar LM. Important aspects of home care service: An interview study of persons with dementia. DEMENTIA 2020; 20:1649-1663. [DOI: 10.1177/1471301220964393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background and Aim Because of the policy of ‘ageing in place’ and a decreasing number of beds in residential settings, more persons with dementia live at home with support from home care services. However, previous studies have revealed more unmet needs and a lower quality of life in this group than in other groups. Because few qualitative studies are performed in which persons with dementia have the opportunity to tell their own stories and describe what they find important, this study aimed to interview persons with dementia and describe their views on the important aspects of receiving home care service. Methods The study used a qualitative approach, and 14 persons with dementia participated in the interviews. The interviews were analysed using qualitative content analysis. Findings The findings revealed one overarching theme. The importance of being supported as a unique and capable human, that is the persons with dementia stated that despite their dementia diagnoses, it was important to be seen as a person with capabilities, although in need of support. This theme was built on three subthemes: being seen as a person, being informed and involved, and being part of a relationship. Conclusions Our study showed that persons with dementia are able to express, formulate and reflect on their needs and preferences about their daily care as well as what is important to them when receiving home care service. Therefore, their point of view should be taken into consideration when planning, providing and evaluating care.
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Affiliation(s)
- Marie Olsen
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Camilla Udo
- School of Education, Health and Social Studies, Dalarna University, Sweden; Center for Clinical Research, Dalarna, Sweden; Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Anne-Marie Boström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Sweden; Theme Ageing, Karolinska University Hospital, Huddinge, Sweden; Stockholms Sjukhem, R&D Unit, Stockholm, Sweden
| | - Lena Marmstål Hammar
- School of Health, Care, and Social Welfare, Mälardalen University, Sweden; School of Education, Health and Social Studies, Dalarna University, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Sweden
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Coleman H, McIntosh A, Wilson SJ. A patient-centered approach to understanding long-term psychosocial adjustment and meaning-making, 15 to 20 years after epilepsy surgery. Epilepsy Behav 2020; 102:106656. [PMID: 31778879 DOI: 10.1016/j.yebeh.2019.106656] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Different psychosocial trajectories have been identified following treatment with epilepsy surgery, as patients adjust to possible changes in seizure frequency and the subsequent impact on their psychosocial functioning. Qualitative research has been key to understanding this adjustment process, particularly in the short-term (2-5 years). Currently, however, there is a lack of qualitative research examining longer-term (>15 years) outcomes, precluding the same rich, detailed understanding of longer-term psychosocial outcomes. Using a grounded theory approach, we explored how patients reflected on and made sense of their adjustment trajectories, 15 to 20 years after surgery. This included the impact of surgery on their sense of self and broader psychosocial functioning. METHODS We recruited 40 adult patients who had undergone anterior temporal lobectomy (ATL) 15 to 20 years ago (24 females; 26 left-sided). Median age at habitual seizure onset was 9.7 years (Interquartile range; IQR = 13.8), and at surgery was 31 years (IQR = 12). Median length of follow-up was 18.4 years (IQR = 4.3). Comprehensive one-on-one interviews (median time = 86 min, IQR = 28) were used to elicit patient experiences of their surgery and subsequent psychosocial outcomes. Data were analyzed using a grounded theory inductive-deductive process. RESULTS Patient narratives revealed a common process of psychosocial change and meaning-making triggered by surgery, which was often perceived as a major turning point in life. Patients reflected on moving through an early postsurgical period (<5 years) of upheaval and psychological disequilibrium. While this period was often remembered as stressful, difficulties were softened and/or reframed in hindsight. Through this process of reframing and meaning-making, patients were able to reestablish equilibrium and a sense of normality. Differences were evident in how patients navigated the process of meaning-making, and the extent to which they felt surgery had changed their self-identity. DISCUSSION We propose a model of postsurgical meaning-making, evident in the narratives of patients who have undergone ATL, providing a new perspective on long-term psychosocial outcomes. This model contributes to our understanding of patient well-being and quality of life, by acknowledging the active role that patients play in seeking to create their own sense of normality after epilepsy surgery.
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Affiliation(s)
- Honor Coleman
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Epilepsy Research Centre, Department of Medicine (Austin Health), University of Melbourne, Australia.
| | - Anne McIntosh
- Epilepsy Research Centre, Department of Medicine (Austin Health), University of Melbourne, Australia; Department of Neurosciences, Medicine, Nursing and Health Sciences, Monash University, Australia; Melbourne Brain Centre, The Royal Melbourne Hospital, Department of Medicine, University of Melbourne, Australia
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Epilepsy Research Centre, Department of Medicine (Austin Health), University of Melbourne, Australia
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Personhood and Dementia Care: A Qualitative Evidence Synthesis of the Perspectives of People With Dementia. THE GERONTOLOGIST 2019; 61:e85-e100. [DOI: 10.1093/geront/gnz159] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background and Objectives
Personhood is considered the cornerstone of person-centered care for people with dementia. However, there is little research on personhood in dementia care from the perspective of the person with dementia themselves. This article presents a qualitative evidence synthesis of the experiences and perceptions of people with dementia on personhood in dementia care.
Research Design and Methods
A systematic search of nine databases was conducted. In addition to initial screening, CART analysis was used to determine the most relevant papers. Thematic synthesis was conducted on 20 papers. The CASP tool was used to examine the quality of the included papers. GRADE CERQual analysis examined confidence in the review findings.
Results
People with dementia experience many changes due to the disease and the experience of being cared for in different settings. Personhood is affirmed through personal interactions with family, friends, other care recipients, and formal caregivers, as well as through continued engagement in social and occupational roles.
Discussion and Implications
The review has important implications for practice, regulation, and policy. The person and their personhood should be protected rather than undermined, and relationships should be enhanced not diminished by the formal care process. The focus should be on creating and amplifying opportunities for people with dementia to affirm the self through interactions with others and engaging in occupational and social roles to ensure continuity of self.
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Dassa A, Harel D. People with dementia as ‘spect-actors’ in a musical theatre group with performing arts students from the community. ARTS IN PSYCHOTHERAPY 2019. [DOI: 10.1016/j.aip.2019.101592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nicholas DB, Orjasaeter JD, Zwaigenbaum L. Considering Methodological Accommodation to the Diversity of ASD: A Realist Synthesis Review of Data Collection Methods for Examining First-Person Experiences. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00164-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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